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SURECIi At P FARM SERVICE <br />28 0 MILLIROR 9448 <br />JU"M54 CI 8 -1121 <br />541 -9 t <br />t <br />Merchant I0: 0702179 <br />Tera ID: 0413 <br />Sale <br />MpSTERCRRD — <br />XXXXXXXXXXXX <br />Entry Method; Suip gat�ha: 000048 <br />paarud; Online 11.22.4 ner <br />0i/13/1 <br />Inva; 00000001 Raar Code; MS11 <br />total: in <br />Customer Copy <br />THANK YOU! <br />DELIVERY SLII'/ BILL OF LADING <br />Sure Crop Farm Service CASH CHG RETURN <br />28410 Milliron Road <br />Junction City, Oregon 97448 <br />(541) 998 -1121 <br />FAX 998 -1620 <br />C•/j — DATE <br />SHIP TO <br />APPLICATOR NO. <br />PURCHASE ORDER NO. <br />COMMODITY ITEM CODE PRICE TOTALS <br />q,2 31 <br />of <br />0 , 0 <br />This Is to certify that the above named materials are properly classified, described, I certify that: 1) 1 have read this invoice and In consideration of this sale, agree to the <br />packaged, marked and labeled, and are In proper condition for transportation, according terms thereof: 2) 1 have been offered for display on my vehicle, four <br />to the applicable regulations of the Department of Transportation. placards. <br />Sure Crop Farm Service SHIPPER By �–°�� y C Signed <br />IMPORTANT NOTICE ON BACK <br />